Individual
EDNA MANCILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - ENDOCRINOLOGY, PHILADELPHIA, PA 19104-4319
(215) 590-3174
(215) 590-3053
Mailing address
100 E PENN SQ, 9TH FLOOR, PHILADELPHIA, PA 19107-3323
(267) 425-9232
(267) 425-9299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25MA08534100
NJ
208000000X
Pediatrics Physician
MD049248L
PA
2080P0205X
Pediatric Endocrinology Physician
25MA08534100
NJ
2080P0205X
Pediatric Endocrinology Physician
Primary
MD049248L
PA
Other
Enumeration date
06/05/2009
Last updated
04/15/2013
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